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August 05, 2020Article

Association of education with Aβ burden in preclinicial familial and sporadic Alzheimer disease

Julie Gonneaud, Christophe Bedetti, Alexa Pichet Binette, Tammie L.S. Benzinger, John C. Morris, View ORCID ProfileRandall J. Bateman, Judes Poirier, John C.S Breitner, View ORCID ProfileSylvia Villeneuve, for The DIAN Study Group3* and for the PREVENT-AD Research Group2,**
First published August 5, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010314
Julie Gonneaud
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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Christophe Bedetti
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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Alexa Pichet Binette
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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Tammie L.S. Benzinger
3 Knight Alzheimer’s Disease Research Center, St. Louis, MO, US;
4 Washington University School of Medicine, St. Louis, MO, US
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John C. Morris
3 Knight Alzheimer’s Disease Research Center, St. Louis, MO, US;
4 Washington University School of Medicine, St. Louis, MO, US
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Randall J. Bateman
3 Knight Alzheimer’s Disease Research Center, St. Louis, MO, US;
4 Washington University School of Medicine, St. Louis, MO, US
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  • ORCID record for Randall J. Bateman
Judes Poirier
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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John C.S Breitner
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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Sylvia Villeneuve
1 Department of Psychiatry, McGill University, Montreal, QC, Canada;
2 Douglas Mental Health University Institute, StoP-AD Centre, Montreal, QC, Canada;
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  • ORCID record for Sylvia Villeneuve
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Citation
Association of education with Aβ burden in preclinicial familial and sporadic Alzheimer disease
Julie Gonneaud, Christophe Bedetti, Alexa Pichet Binette, Tammie L.S. Benzinger, John C. Morris, Randall J. Bateman, Judes Poirier, John C.S Breitner, Sylvia Villeneuve, for The DIAN Study Group3* and for the PREVENT-AD Research Group2,**
Neurology Aug 2020, 10.1212/WNL.0000000000010314; DOI: 10.1212/WNL.0000000000010314

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Abstract

Objective. To determine whether years of education and the ε4 risk allele at APOE influence β-amyloid pathology similarly in asymptomatic individuals with a family history of sporadic Alzheimer’s disease (AD) and pre-symptomatic autosomal dominant AD mutation carriers.

Methods. We analyzed cross-sectional data from 106 asymptomatic individuals with a parental history of sporadic AD (PREVENT-AD cohort; age=67.28±4.72 years) and 117 pre-symptomatic autosomal dominant AD mutation carriers (DIAN cohort; age=34.00±9.43 years). All participants underwent structural MRI and β-amyloid PET imaging. In each cohort we investigated the influence of years of education, APOE-ε4 status and their interaction on β-amyloid PET.

Results. Asymptomatic individuals with a parental history of sporadic AD showed increased β-amyloid burden associated with APOE-ε4 carriage and lower level of education, but no interaction between these. Pre-symptomatic mutation carriers of autosomal dominant AD showed no relation between APOE-ε4 and β-amyloid burden, but increasing level of education was associated with reduced β-amyloid burden. The association between educational attainment and β-amyloid burden was similar in the two cohorts.

Conclusions. While the APOE-ε4 allele confers increased tendency toward β-amyloid accumulation in sporadic AD only, protective environmental factors, like increased education, may promote brain resistance against β-amyloid pathology in both sporadic and autosomal dominant AD.

  • Received July 2, 2019.
  • Accepted in final form March 23, 2020.
  • © 2020 American Academy of Neurology

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